细胞角蛋白19、甲状腺转录因子-1与甲状腺癌的关系探讨

Exploration on Correlation between Thyroid Cancer and Cytokeratin 19 as well as Thyroid Transcription Factors

目的检测甲状腺组织标本中细胞角蛋白19(CKl9)及甲状腺转录因子-1(TTF-1)的表达情况,评价其在鉴别甲状腺乳头状癌恶性程度高低方面的应用价值,提高对甲状腺乳头状癌恶性程度高低的诊断和外科治疗水平。方法回顾性分析某院2006—2009年67例因甲状腺乳头状癌住院手术治疗的患者资料,在其石蜡标本中用免疫组化检测CKl9及TTF-1蛋白的表达情况,并根据肿瘤大小、范围、有无钙化、有无远处转移等经验性指标的比较来提高甲状腺乳头状癌恶性程度高低的鉴别诊断的准确率,指导临床治疗。结果几乎所有乳头状癌CK19表达均为阳性以上。合并良性甲状腺结节的病例中良性结节的CK19无表达。TTF-1在良恶性结节中的表达情况无明显统计学差异。甲状腺乳头状癌恶性程度高的病例,其TTF-1表达阳性率高,并且有统计学意义。结论 CK19是甲状腺乳头状癌病理诊断中非常有价值的辅助诊断指标,是区分甲状腺乳头状癌和乳头状增生很好的标志物。TTF-1对于鉴别甲状腺结节良恶性无明显临床意义,但其有助于判别甲状腺乳头状癌恶性程度高低,为手术切除肿瘤范围等提供一定的参考。

Objective To detect the expression of cytokeratin 19 (CKl9) and thyroid transcription factors 1(TTF-1) in the thyroid tissue specimens,and to assess the diagnostic value at differentiating between benign and malignant thyroid nodules,so as to improve the diagnosis and surgical treatment of patients with thyroid nodule.Methods Retrospective analysis was conducted of 67 cases of thyroid papillary carcinoma in the surgical treatment of patients in 2006-2009,with analysis of the clinical characteristics and pathological results.According to the index of tumor size,scope,calcification,the presence of distant metastasis and other critical ones,we tried to improve the diagnosis accuracy of thyroid papillary carcinoma malignant level,and guide the clinical treatment.In 67 paraffin wax specimens of patients with thyroid papillary carcinoma,Immunohistochemical detection was used to detect the protein expression level of these organizations' CKl9 and TTF-1.Results Almost all papillary carcinoma CK19 expression were positive above.In benign thyroid nodule cases,the nodules had no CK19 expression.TTF-1’s expression had no significant difference in Benign and malignant nodules.In the cases of pupillary thyroid carcinoma with high malignant degree,the TTF-1 had a higher positive,and a high statistical significance.Conclusion CK19 is a very valuable indicator in the diagnosis of pathological of papillary thyroid carcinoma and a good marker in distinguishing papillary thyroid carcinoma and papillary hyperplasia.As for benign and malignant thyroid nodule,there is no obvious clinical significance of TTF-1’s expression.But it may help determine malignant level of thyroid papillary carcinoma,providing certain reference for ranges in surgical tumor resection.